No Child Left to Die
Joyce Kamwana got lucky. The mother of two went to the doctor after running a fever, thinking she had malaria. After running tests, the doctor told Kamwana she was HIV-positive. That was 1988, three years after the first case of HIV/AIDS was diagnosed in the East African nation of Malawi.
Kamwana had contracted the disease from her husband, Dan, who would die from AIDS three years later. Their daughter, Sharon, tested negative for the virus. But their newborn, Tracy, tested positive. After Kamwana finished breastfeeding, more tests were run, and Tracy tested HIV-free. Both girls eventually went to college and were able to donate blood without risk.
"It's quite a relief to say I have only myself to think about now," Kamwana said. "I'm very proud of them. Lord, thank you. You've done a very good job."
Not every mother living with HIV is as fortunate. Globally, about 1,000 HIV-positive children are born each day. In many developing nations, contracting HIV from one's mother is a death sentence: 50 percent of children who get the disease from their mothers die before their second birthday. Without drug treatment, an HIV-positive pregnant woman has a one in three chance of infecting her child during pregnancy, labor and delivery, or through breastfeeding.
Ninety-one percent of children born with HIV live in African nations with very high birth and infant mortality rates. Young children in Uganda, for example, die by the tens of thousands, as the nation has one of the world's highest birth, infant mortality, and HIV infection rates, not to mention deaths from tuberculosis, malaria, and other diseases (see "Standing in the (AIDS) Gap,").
Pregnant women with HIV need antiretroviral drugs the most. A 2000 Johns Hopkins University study found that when a pregnant woman takes a single dose of nevirapine (an antiretroviral drug) at the beginning of labor, and her baby takes a dose after birth, the baby's chances of contracting the virus are cut in half, from about 30 percent down to 15 percent.
More recently, researchers have found that a regimen of antiretroviral drugs given to a mother from early in pregnancy to after breastfeeding can reduce the chance of transmission down to about 4 percent. Stephen Lee, senior program director for the prevention, care, and treatment services team at the Elizabeth Glaser Pediatric AIDS Foundation, said, "If we can get to under 4 percent of [at-risk] infants being born with HIV, we've accomplished a lot."
The greatest challenge is making the new triple-drug regimens and related programs available where they are most needed.
Treatment costs between $100 and $140 per year. But only 42 percent of the 33.4 million people worldwide living with HIV have access to ongoing drug treatment. In response, a growing group of faith-based leaders have endorsed the ambitious goal of eliminating mother-child HIV transmission by year 2015. Adam Phillips, faith relations manager for the ONE Campaign, an advocacy organization co-founded by U2 frontman Bono, told Christianity Today, "This is something we can completely stop. We have the medicine and the know-how. For us it's an imperative to stop it."
ONE's efforts are gathering steam. In May, the Global Fund, which raises billions of dollars for public-health programs in developing countries, launched the Born HIV Free campaign. In October, at the Global Fund Replenishment Meetings, President Obama pledged $4 billion, a 38 percent increase from the previous pledge. The United Methodist Church gave $28 million to the Global Fund in 2010. The fund has commitments to receive $11.7 billion over the next three years. With that money, it will put more people living with HIV/AIDS on daily drug therapy, support more of the 14 million AIDS orphans, and almost double the number of HIV-positive pregnant women receiving preventive services.